Rippe J M, Crossley S, Ringer R
Center for Clinical and Lifestyle Research, Shrewsbury, MA 01545, USA.
J Am Diet Assoc. 1998 Oct;98(10 Suppl 2):S9-15. doi: 10.1016/s0002-8223(98)00704-4.
The United States is in the midst of an epidemic of obesity involving more than one third of the adult population. The prevalence of obesity increased by 40% between 1980 and 1990. Obesity is a chronic disease with a multifactorial etiology including genetics, environment, metabolism, lifestyle, and behavioral components. A chronic disease treatment model involving both lifestyle interventions and, when appropriate, additional medical therapies delivered by an interdisciplinary team including physicians, dietitians, exercise specialists, and behavior therapists offers the best chance for effective obesity treatment. Lifestyle factors such as proper nutrition, regular physical activity, and changes in eating behaviors should be coordinated by this team. This review addresses the modern epidemic of obesity, the strong association between obesity and comorbidities such as coronary heart disease, type 2 diabetes, hypertension, and dyslipidemia. In addition to obesity, the health risks of abdominal obesity and adult weight gain are discussed. The evidence that supports health benefits from modest weight loss (between 5% and 10% of body weight) is evaluated and the 5 key principles of effective obesity therapy are put forward. Obesity is a therapeutic challenge best met by teams of health care professionals, including dietitians and physicians, working together to deliver optimal treatment.
美国正处于一场肥胖症流行之中，超过三分之一的成年人口受其影响。1980年至1990年间，肥胖症患病率上升了40%。肥胖是一种具有多因素病因的慢性疾病，包括遗传、环境、代谢、生活方式和行为因素。一种慢性疾病治疗模式，包括生活方式干预，以及在适当情况下由包括医生、营养师、运动专家和行为治疗师在内的跨学科团队提供的额外医学疗法，为有效治疗肥胖症提供了最佳机会。该团队应协调适当营养、定期体育活动和饮食行为改变等生活方式因素。本综述探讨了现代肥胖症流行情况，以及肥胖与冠心病、2型糖尿病、高血压和血脂异常等合并症之间的紧密关联。除了肥胖症，还讨论了腹部肥胖和成人体重增加对健康的风险。评估了支持适度体重减轻（体重的5%至10%）对健康有益的证据，并提出了有效肥胖症治疗的5项关键原则。肥胖是一个治疗挑战，最好由包括营养师和医生在内的医疗保健专业人员团队共同努力，提供最佳治疗方案来应对。
